Public Health since the beginning: Neonatal incubators safety in a clinical setting.

BACKGROUND: The role of environmental cleaning as an effective measure to contain the diffusion of Healthcare Associated Infections (HAIs) has already been demonstrated. Among medical devices, neonatal incubators have been recognized as a source of pathogens involved in the spread of HAIs. Aim of the study was to assess the efficacy of a disinfection protocol for neonatal incubators. METHODS: The cross sectional study took place in the "Neonatal Pediatric Unit" of the Teaching Hospital of Siena: twenty incubators, used for critical newborns, were swabbed in 13 sampling points before and after the implementation of the disinfection protocol. Sanitation procedures were performed by trained staff, implementing the product Umonium38® Neutralis as disinfectant. Different culture media for the identification of the microbial contamination were adopted: plates were incubated for the proper time and the results were referred to Colony Forming Units (CFUs)/swab per point. Descriptive statistical analysis was performed. It was also evaluated the 95% confidence interval (C.I.) of the mean and the percentage of CFUs reduction by the bootstrap bias corrected and accelerated resampling method. RESULTS: Matched points analyzed were 313. The average CFUs percentage of reduction was 93.5% [C.I. 90.6-95.9%]: it was higher, 97.0% [C.I. 94.1-99.1%], in points placed inside the incubators structure compared to the 88.4% [C.I. 83.6-93.0%] obtained outside. CONCLUSION: The disinfection protocol achieved good results. Routine surveillance and supervision of the various aspects of the disinfection processes (procedures, staff and disinfectants) could guarantee a safe environment during the first days of babies' life, avoiding harmful conditions for the newborns' health.

A novel approach to stethoscope hygiene: A coat-pocket innovation.

BACKGROUND: The stethoscope is the most widely used instrument in healthcare. Studies have found similar rates of contamination on the stethoscope diaphragm and on physician fingertips after a single examination. Our aim was to test the effectiveness of an innovative portable device for disinfecting stethoscope membranes. METHODS: From November 2016 to May 2017, a cross-sectional study was conducted in four wards of a private clinic: General Ward (GW), Internal Medicine Ward (IMW), Post-Operative Observation Ward (POW) and Permanent Vegetative State Ward (PVSW). Five wearable medical devices, designed to disinfect stethoscope membranes automatically by means of UV-C radiation, were provided to operators. Spot checks were made for microbial counts of stethoscope membranes, classified as treated or otherwise on the basis of whether they were found coupled or otherwise with the devices. The percentage reduction in colony forming units (CFU) was calculated between the two groups. RESULTS: The number of tests of stethoscopes treated with the device was 116 out of 272. Untreated samples had a mean contamination of 132.2 CFU versus 6.9 CFU of treated samples: a 94.8% reduction (95% CI 91.3%-97.7). Highly significant statistical differences in CFU were found between untreated and treated membranes (p < 0.001). In particular, microbial contamination showed a reduction of 88.7% (CI 77.5%-96.05%) in PVSW, 95.9% (CI 88.2%-98.5%) in GW, 84.5% (CI 76.4%-90.5%) in IMW and 95.8% (CI 90.3%-98.1%) in POW. CONCLUSION: The devices proved effective and efficient in reducing the microbial load of stethoscope membranes. Wearing the device on the coat may act as a reminder of the need for hygiene.

A new UV-LED device for automatic disinfection of stethoscope membranes.

BACKGROUND: Stethoscopes are widely used by doctors and nurses. Poor stethoscope hygiene is a potential source of nosocomial infection. This study aimed to propose an innovative solution, based on the latest advances in ultraviolet (UV) light-emitting diodes (LEDs), for disinfecting stethoscope membranes automatically and efficiently. METHODS: Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Enterococcus faecalis were sown on 28 stethoscope membranes and then transferred to Petri dishes. Treatment involved illuminating exposed Petri dishes with a UVC LED for 1 minute. For each microbe, the number of colony-forming units (cfu) at 36°C was compared in control and treated dishes using the Wilcoxon signed-rank test. The Kruskal-Wallis test was used to assess percent reductions in bacteria. Statistical significance was set at 99%. RESULTS: A significant reduction in cfu counts after UV treatment (P < .01) was found for all bacteria: 85.5% for E faecalis, 87.5% for S aureus, 94.3% for E coli, and 94.9% for P aeruginosa . No significant differences in percent reduction in cfu were found between bacteria (P > .01). CONCLUSION: The stethoscope, symbol of medicine and health care professionals, has been demonstrated to be a carrier of microorganisms. The treatment technique was effective and efficient in disinfecting the membranes. These promising results represent a step forward toward eliminating stethoscope membrane contamination with an innovative approach.

Is it possible to sanitize athletes' shoes?

CONTEXT: Footwear should be designed to avoid trauma and injury to the skin of the feet that can favor bacterial and fungal infections. Procedures and substances for sanitizing the interior of shoes are uncommon but are important aspects of primary prevention against foot infections and unpleasant odor. OBJECTIVE: To evaluate the efficacy of a sanitizing technique for reducing bacterial and fungal contamination of footwear. DESIGN: Crossover study. SETTING: Mens Sana basketball team. PATIENTS OR OTHER PARTICIPANTS: Twenty-seven male athletes and 4 coaches (62 shoes). INTERVENTION(S): The experimental protocol required a first sample (swab), 1/shoe, at time 0 from inside the shoes of all athletes before the sanitizing technique began and a second sample at time 1, after about 4 weeks, April 2012 to May 2012, of daily use of the sanitizing technique. MAIN OUTCOME MEASURE(S): The differences before and after use of the sanitizing technique for total bacterial count at 36 °C and 22 °C for Staphylococcus spp, yeasts, molds, Enterococcus spp, Pseudomonas spp, Escherichia coli , and total coliform bacteria were evaluated. RESULTS: Before use of the sanitizing technique, the total bacterial counts at 36 °C and 22 °C and for Staphylococcus spp were greater by a factor of 5.8 (95% confidence interval [CI] = 3.42, 9.84), 5.84 (95% CI = 3.45, 9.78), and 4.78 (95% CI = 2.84, 8.03), respectively. All the other comparisons showed a reduction in microbial loads, whereas E coli and coliforms were no longer detected. No statistically significant decrease in yeasts (P = .0841) or molds (P = .6913) was recorded probably because of low contamination. CONCLUSIONS: The sanitizing technique significantly reduced the bacterial presence in athletes' shoes.

Environmental contaminants in hospital settings and progress in disinfecting techniques.

Medical devices, such as stethoscopes, and other objects found in hospital, such as computer keyboards and telephone handsets, may be reservoirs of bacteria for healthcare-associated infections. In this cross-over study involving an Italian teaching hospital we evaluated microbial contamination (total bacterial count (TBC) at 36°C/22°C, Staphylococcus spp., moulds, Enterococcus spp., Pseudomonas spp., E. coli, total coliform bacteria, Acinetobacter spp., and Clostridium difficile) of these devices before and after cleaning and differences in contamination between hospital units and between stethoscopes and keyboards plus handsets. We analysed 37 telephone handsets, 27 computer keyboards, and 35 stethoscopes, comparing their contamination in four hospital units. Wilcoxon signed-rank and Mann-Whitney tests were used. Before cleaning, many samples were positive for Staphylococcus spp. and coliforms. After cleaning, CFUs decreased to zero in most comparisons. The first aid unit had the highest and intensive care the lowest contamination (P < 0.01). Keyboards and handsets had higher TBC at 22°C (P = 0.046) and mould contamination (P = 0.002) than stethoscopes. Healthcare professionals should disinfect stethoscopes and other possible sources of bacterial healthcare-associated infections. The cleaning technique used was effective in reducing bacterial contamination. Units with high patient turnover, such as first aid, should practise stricter hygiene.